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Why is type 1 diabetes increasing?

Abstract

A series of studies have reported a constant global rise in the incidence of type 1 diabetes. Epidemiological and immunological studies have demonstrated that environmental factors may influence the pathogenesis, leading to a cell-mediated pancreatic β-cell destruction associated with humoral immunity. The search for the triggering factor(s) has been going on for the past century, and yet they are still unknown. This review provides an overview of some of the most well-known theories found in the literature: hygiene, viral, vitamin D deficiency, breast milk and cow's milk hypotheses. Although the hygiene hypothesis appears to be the most promising, positive evidence from animal, human and epidemiological studies precludes us from completely discarding any of the other hypotheses. Moreover, due to contrasting evidence in the literature, a single factor is unlikely to cause an increase in the incidence of diabetes all over the world, which suggests that a multifactorial process might be involved. Although the immunological mechanisms are still unclear, there seems to be some overlap between the various hypotheses. It is thought that the emphasis should be shifted from a single to a multifactorial process and that perhaps the 'balance shift' model should be considered as a possible explanation for the rise in the incidence of type 1 diabetes.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Cellular and Molecular Medicine, University of Bristol, 53 Arley Hill, Bristol BS6 5PJ, UK. francescoegro@gmail.com

    Source

    MeSH

    Animals
    Diabetes Mellitus, Type 1
    Humans
    Models, Biological

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    23733895

    Citation

    Egro, Francesco Maria. "Why Is Type 1 Diabetes Increasing?" Journal of Molecular Endocrinology, vol. 51, no. 1, 2013, pp. R1-13.
    Egro FM. Why is type 1 diabetes increasing? J Mol Endocrinol. 2013;51(1):R1-13.
    Egro, F. M. (2013). Why is type 1 diabetes increasing? Journal of Molecular Endocrinology, 51(1), pp. R1-13. doi:10.1530/JME-13-0067.
    Egro FM. Why Is Type 1 Diabetes Increasing. J Mol Endocrinol. 2013;51(1):R1-13. PubMed PMID: 23733895.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Why is type 1 diabetes increasing? A1 - Egro,Francesco Maria, Y1 - 2013/07/12/ PY - 2013/6/5/entrez PY - 2013/6/5/pubmed PY - 2014/1/8/medline KW - balance shift KW - breast milk KW - cow's milk KW - diabetes 1 KW - hygiene KW - hypotheses KW - immunology KW - increase KW - mechanism KW - review KW - rise KW - viral KW - vitamin D deficiency SP - R1 EP - 13 JF - Journal of molecular endocrinology JO - J. Mol. Endocrinol. VL - 51 IS - 1 N2 - A series of studies have reported a constant global rise in the incidence of type 1 diabetes. Epidemiological and immunological studies have demonstrated that environmental factors may influence the pathogenesis, leading to a cell-mediated pancreatic β-cell destruction associated with humoral immunity. The search for the triggering factor(s) has been going on for the past century, and yet they are still unknown. This review provides an overview of some of the most well-known theories found in the literature: hygiene, viral, vitamin D deficiency, breast milk and cow's milk hypotheses. Although the hygiene hypothesis appears to be the most promising, positive evidence from animal, human and epidemiological studies precludes us from completely discarding any of the other hypotheses. Moreover, due to contrasting evidence in the literature, a single factor is unlikely to cause an increase in the incidence of diabetes all over the world, which suggests that a multifactorial process might be involved. Although the immunological mechanisms are still unclear, there seems to be some overlap between the various hypotheses. It is thought that the emphasis should be shifted from a single to a multifactorial process and that perhaps the 'balance shift' model should be considered as a possible explanation for the rise in the incidence of type 1 diabetes. SN - 1479-6813 UR - https://www.unboundmedicine.com/medline/citation/23733895/full_citation L2 - https://jme.bioscientifica.com/doi/10.1530/JME-13-0067 DB - PRIME DP - Unbound Medicine ER -